Early evaluation of the Children and Young People's Mental Health Trailblazer programme: a rapid mixed-methods study.

J. Ellins, Lucy Hockings, M. Al-Haboubi, J. Newbould, Sarah-Jane Fenton, Daniel E. Kelly, Stephanie Stockwell, Brandi Leach, M. Sidhu, J. Bousfield, G. McKenna, Katie Saunders, Stephen O'Neil, N. Mays
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A new workforce of education mental health practitioners is being trained for the teams.\n\n\nObjective(s)\nThe National Institute for Health and Care Research Birmingham, RAND and Cambridge Evaluation Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit undertook an early evaluation of the Trailblazer programme to examine the development, implementation and early progress of mental health support teams in the programme's first 25 'Trailblazer' sites.\n\n\nDesign\nA mixed-methods evaluation, comprising three work packages: 1. Establishing the baseline and understanding the development and early impacts of the Trailblazer sites, including two rounds of surveys with key informants and participating education settings in all 25 sites. 2. More detailed research in five purposively selected Trailblazer sites, including interviews with a range of stakeholders and focus groups with children and young people. 3. Scoping and developing options for a longer-term assessment of the programme's outcomes and impacts. Fieldwork was undertaken between November 2020 and February 2022. The University of Birmingham Institute for Mental Health Youth Advisory Group was involved throughout the study, including co-producing the focus groups with children and young people.\n\n\nResults\nSubstantial progress had been made implementing the programme, in challenging circumstances, and there was optimism about what it had the potential to achieve. The education mental health practitioner role had proven popular, but sites reported challenges in retaining education mental health practitioners, and turnover left mental health support teams short-staffed and needing to re-recruit. Education settings welcomed additional mental health support and reported positive early outcomes, including staff feeling more confident and having faster access to advice about mental health issues. At the same time, there were concerns about children who had mental health problems that were more serious than 'mild to moderate' but not serious enough to be accepted for specialist help, and that the interventions offered were not working well for some young people. Mental health support teams were generally spending more time supporting children with mental health problems than working with education settings to develop 'whole school' approaches to mental health and well-being, and service models in some sites appeared to be more clinically oriented, with a strong focus on mental health support teams' therapeutic functions.\n\n\nLimitations\nDespite efforts to maximise participation, survey response rates were relatively low and some groups were less well represented than others. We were not able to gather sufficiently detailed data to develop a typology of Trailblazer sites, as was planned.\n\n\nConclusions\nKey lessons for future programme implementation include: - Whether mental health support teams should expand support to children and young people with more complex and serious mental health problems. - How to keep the twin aims of prevention and early intervention in balance. - How to retain education mental health practitioners once trained.\n\n\nFuture work\nThe findings have important implications for the design of a longer-term impact evaluation of the programme, which is due to commence in summer 2023.\n\n\nStudy registration\nEthical approval from the University of Birmingham (ERN_19-1400 - RG_19-190) and London School of Hygiene and Tropical Medicine (Ref: 18040) and Health Research Authority approval (IRAS 270760).\n\n\nFunding\nThe Birmingham, RAND and Cambridge Evaluation Rapid Evaluation Centre is funded by the National Institute for Health and Care Research Health Services and Delivery Research programme (HSDR 16/138/31). The Policy Innovation and Evaluation Research Unit is funded by the NIHR Policy Research Programme (PR-PRU-1217-20602).","PeriodicalId":73204,"journal":{"name":"Health and social care delivery research","volume":"11 8 1","pages":"1-137"},"PeriodicalIF":0.0000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health and social care delivery research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3310/hsdr-tr-130818","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5

Abstract

Background The Children and Young People's Mental Health Trailblazer programme is funding the creation of new mental health support teams to work in schools and further education colleges. Mental health support teams directly support children and young people with 'mild to moderate' mental health problems and work with school and college staff to promote well-being for all. A new workforce of education mental health practitioners is being trained for the teams. Objective(s) The National Institute for Health and Care Research Birmingham, RAND and Cambridge Evaluation Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit undertook an early evaluation of the Trailblazer programme to examine the development, implementation and early progress of mental health support teams in the programme's first 25 'Trailblazer' sites. Design A mixed-methods evaluation, comprising three work packages: 1. Establishing the baseline and understanding the development and early impacts of the Trailblazer sites, including two rounds of surveys with key informants and participating education settings in all 25 sites. 2. More detailed research in five purposively selected Trailblazer sites, including interviews with a range of stakeholders and focus groups with children and young people. 3. Scoping and developing options for a longer-term assessment of the programme's outcomes and impacts. Fieldwork was undertaken between November 2020 and February 2022. The University of Birmingham Institute for Mental Health Youth Advisory Group was involved throughout the study, including co-producing the focus groups with children and young people. Results Substantial progress had been made implementing the programme, in challenging circumstances, and there was optimism about what it had the potential to achieve. The education mental health practitioner role had proven popular, but sites reported challenges in retaining education mental health practitioners, and turnover left mental health support teams short-staffed and needing to re-recruit. Education settings welcomed additional mental health support and reported positive early outcomes, including staff feeling more confident and having faster access to advice about mental health issues. At the same time, there were concerns about children who had mental health problems that were more serious than 'mild to moderate' but not serious enough to be accepted for specialist help, and that the interventions offered were not working well for some young people. Mental health support teams were generally spending more time supporting children with mental health problems than working with education settings to develop 'whole school' approaches to mental health and well-being, and service models in some sites appeared to be more clinically oriented, with a strong focus on mental health support teams' therapeutic functions. Limitations Despite efforts to maximise participation, survey response rates were relatively low and some groups were less well represented than others. We were not able to gather sufficiently detailed data to develop a typology of Trailblazer sites, as was planned. Conclusions Key lessons for future programme implementation include: - Whether mental health support teams should expand support to children and young people with more complex and serious mental health problems. - How to keep the twin aims of prevention and early intervention in balance. - How to retain education mental health practitioners once trained. Future work The findings have important implications for the design of a longer-term impact evaluation of the programme, which is due to commence in summer 2023. Study registration Ethical approval from the University of Birmingham (ERN_19-1400 - RG_19-190) and London School of Hygiene and Tropical Medicine (Ref: 18040) and Health Research Authority approval (IRAS 270760). Funding The Birmingham, RAND and Cambridge Evaluation Rapid Evaluation Centre is funded by the National Institute for Health and Care Research Health Services and Delivery Research programme (HSDR 16/138/31). The Policy Innovation and Evaluation Research Unit is funded by the NIHR Policy Research Programme (PR-PRU-1217-20602).
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儿童和青少年心理健康开拓者计划的早期评估:一项快速混合方法研究。
背景儿童和青少年心理健康开拓者计划正在资助成立新的心理健康支持团队,在学校和继续教育学院工作。心理健康支持团队直接支持有“轻度至中度”心理健康问题的儿童和年轻人,并与学校和大学工作人员合作,促进所有人的福祉。正在为这些团队培训一批新的教育、心理健康从业者。目的:伯明翰国家卫生与保健研究所、兰德公司和剑桥评估快速评估中心以及政策创新和评估研究单位对开拓者计划进行了早期评估,以检查该计划首批25个“开拓者”地点的心理健康支持团队的发展、实施和早期进展。设计一种混合方法评估,包括三个工作包:1。建立基线,了解开拓者遗址的发展和早期影响,包括与关键信息提供者和所有25个遗址的参与教育机构进行两轮调查。2.对五个有目的地选择的开拓者网站进行更详细的研究,包括对一系列利益相关者和儿童和年轻人焦点小组的采访。3.确定方案成果和影响的范围并制定长期评估备选方案。实地调查于2020年11月至2022年2月期间进行。伯明翰大学心理健康研究所青年咨询小组参与了整个研究,包括与儿童和年轻人共同制作焦点小组。结果在充满挑战的情况下,该方案的执行取得了实质性进展,人们对该方案有可能实现的目标持乐观态度。事实证明,教育心理健康从业者的角色很受欢迎,但网站报告称,在留住教育心理健康从业人员方面存在挑战,人员流动导致心理健康支持团队人手不足,需要重新招聘。教育机构欢迎额外的心理健康支持,并报告了积极的早期结果,包括工作人员感到更加自信,能够更快地获得有关心理健康问题的建议。与此同时,有人担心,儿童的心理健康问题比“轻度到中度”更严重,但严重程度不足以接受专家帮助,而且所提供的干预措施对一些年轻人来说效果不佳。心理健康支持团队通常花更多的时间支持有心理健康问题的儿童,而不是与教育机构合作开发“全校”的心理健康和幸福方法,一些网站的服务模式似乎更注重临床,重点关注心理健康支持组队的治疗功能。限制尽管努力最大限度地提高参与度,但调查回复率相对较低,一些群体的代表性不如其他群体。我们无法按照计划收集足够详细的数据来开发开拓者场地的类型。结论未来计划实施的关键经验教训包括:-心理健康支持团队是否应该扩大对有更复杂和更严重心理健康问题的儿童和年轻人的支持。-如何保持预防和早期干预的双重目标的平衡如何留住受过培训的心理健康从业者。未来工作这些发现对该计划的长期影响评估的设计具有重要意义,该评估将于2023年夏天开始。研究注册获得伯明翰大学(ERN19-1400-RG_19-190)和伦敦卫生与热带医学院(参考号:18040)的伦理批准和卫生研究局的批准(IRAS 270760),兰德公司和剑桥评估快速评估中心由国家卫生与保健研究所卫生服务和交付研究计划(HSDR 16/138/31)资助。政策创新和评估研究单位由美国国立卫生研究院政策研究计划(PR-PRU-1217-2062)资助。
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